Oligohydramnios with amnio-chorionic separation at 15–16 weeks' gestation

Nine patients with oligohydramnios and amnio-chorionic separation were identified out of 7000 women who underwent a vaginal ultrasound examination at 15–16 weeks' gestation. Oligohydramnios was defined as a reduced amount of amniotic fluid, a distance of more than 1 cm between the chorion and amnion, and a good turgor of the amnion without floating membranes or intrauterine sheets. Fetal malformations were observed in all nine cases. In four of six fetuses where chromosomal analysis was available, an abnormal karyotype was found. It is concluded that oligohydramnios in the early second trimester is associated with fetal abnormality.     

Early second-trimester diagnosis of sirenomelia

Two cases of sirenomelia are described, detected in the 14th and 16th weeks of gestation by transvaginal ultrasonography. A hypothesis for the aetiology of sirenomelia and its associated anomalies is discussed.     

Prenatal sonographic signs of possible fetal genital anomalies

The sonographic markers of female and male external genitalia have been documented in early and late gestation. The aim of the present study was to report our experience of possible sonographic markers of fetal genital anomalies. Sonography was performed with a vaginal probe in early gestation and an abdominal sector scanner in advanced gestation. The following genital anomalies were observed: hypospadias, epispadias, ambiguous genitalia, and testicular feminization or Smith-Lemli-Opitz syndrome. It is therefore concluded that prenatal diagnosis of some genital anomalies is now possible.     

Prenatal diagnosis of autosomal recessive osteopetrosis,infantile type,by X-ray evaluation

Prenatal diagnosis for infantile osteopetrosis was attempted during the third pregnancy of a first-cousin marriage whose family history revealed an affected previous child. At the 25th week of pregnancy, fetal X-ray evaluation revealed marked sclerosis of osteopetrotic bone and metaphyseal splaying and clubbing of both femurs. The pregnancy was terminated and repeated X-rays and histopathological examination of fetal bone (femur) confirmed the diagnosis.     

Amniocentesis rate and the detection of down syndrome and other chromosomal anomalies in Israel

We investigated the contribution of different screening criteria to the prenatal detection of Down syndrome (DS) as well as other chromosomal anomalies in the Jewish population in Israel during 1990 and 1992. There was a significant decrease (P<0·03) in the incidence of DS live-births during 1992 (40:78 442) compared with 1990 (69:73 751) which paralleled a marked increase in total prenatal testing and in DS cases detected prenatally. Private laboratories, which perform amniocenteses mostly for women with a low risk of DS and without genetic counselling, had a significantly lower detection rate (1:917) compared with that of the genetic institutes, which following genetic counselling test both women ≥ 37 years of age (1:91) and women younger than 37 years (1:113). The detection of chromosomal anomalies other than DS was less affected by the reason for amniocentesis. Amniocentesis indicated by maternal serum marker screening of women younger than 37 years identified a greater number of chromosomal anomalies other than DS than amniocentesis based on age (≥37 years) alone (111:9604 versus 94:9810; P<0·06). Prenatal detection of DS is most effective when the indication for amniocentesis follows genetic counselling. The increasing use of maternal serum marker screening leads to a significant improvement in the positive detection rate of chromosomal anomalies other than DS in young women.     

Flooding: what is the impact on pregnancy and child health?

Floods are the most common type of natural disaster in both developed and developing countries and have led to extensive morbidity and mortality throughout the world. Worldwide, over the past 30 years, flooding has claimed the lives of more than 200,000 people and affected more than 2.8 billion others. The impact of flooding on health varies among populations and depends primarily on vulnerability and the kind of event experienced. It severely disrupts livelihoods and has a significant impact on the health of pregnant women and children. In addition, it may exacerbate a range of negative psychological and physiological child and reproductive health outcomes. Awareness‐raising, education, and the issuing of warnings appear to be key initiatives to mitigate or prevent flood morbidity and mortality, especially among people living in low‐ and middle‐income countries. Agencies responding to emergencies also need to be more cognisant of the dangers, specifically those engaged in healthcare, nutrition, and water safety programmes.     

The effects of daily cover soils on shear strength of municipal solid waste in bioreactor landfills

Bioreactor landfills are operated to enhance refuse decomposition, gas production, and waste stabilization. The major aspect of bioreactor landfill operation is the recirculation of collected leachate back through the refuse mass. Due to the accelerated decomposition and settlement of solid waste, bioreactor landfills are gaining popularity as an alternative to the conventional landfill. The addition or recirculation of leachate to accelerate the waste decomposition changes the geotechnical characteristics of waste mass. The daily cover soils, usually up to 20–30% of total MSW volumes in the landfill, may also influence the decomposition and shear strength behavior of MSW. The objective of this paper is to study the effects of daily covers soils on the shear strength properties of municipal solid waste (MSW) in bioreactor landfills with time and decomposition. Two sets of laboratory-scale bioreactor landfills were simulated in a laboratory, and samples were prepared to represent different phases of decomposition. The state of decomposition was quantified by methane yield, pH, and volatile organic content (VOC). Due to decomposition, the matrix structure of the degradable solid waste component was broken down and contributed to a significant decrease in the reinforcing effect of MSW. However, the daily cover soil, a non-degradable constituent of MSW, remains constant. Therefore, the interaction between daily cover soil particles and MSW particles will affect shear strength behavior. A number of triaxial tests were performed to evaluate the shear strength of MSW. The test results indicated that the shear strength of MSW was affected by the presence of cover soils. The friction angle of MSW with the presence of cover soil is higher than the friction angle of MSW without any cover soils. The friction angle of MSW increased from 27° to 30° due to the presence of cover soils for Phase 1 samples. The increased strength was attributed to the friction nature of sandy soil that was used as daily covers soils. Therefore, the effects of cover soils on the shear strength properties of MSW should be evaluated and taken into consideration during stability analyses and design.     

Congenital generalized cystic lymphangiomatosis diagnosed by prenatal ultrasound

We describe a previously unknown congenital abnormality of the lymphatic system, characterized by multiple cystic lesions of the lower extremities and thorax. Diagnosis was made by ultrasound in the second trimester. The ultrasound findings, pathology results, and differential diagnosis are presented.     

Prenantal diagnosis of X-linked hydrocephaly

A case of X-linked hydrocephaly is presented. Early second trimester evaluation of the size of the lateral cerebral ventricles resulted in onemale fetus cfontinuing further normal developmentand one male fetus being abroted because of progressive hydrocephaly. The affected fetus was characterized by cerebral ventricular dilation without aqueductal stenosis. This case history shows the feasibility of early monitoring of pregnancies at risk of X-linked hydrocephaly. In some cases, ventricular enlargement rather than aqueductal stenosis may be the primary lesion.     

In utero ultrasonographic features of campomelic dysplasia

A prenatal diagnosis of campomelic dysplasia in a primigravida is described. First level fetal ultrasonography demonstrated bowing and shortening of lower limbs. Second level examination allowed the correct diagnosis by demonstrating several skeletal anomalies pathognomonic of campomelic dysplasia.